BACKGROUND: The aim of study was an evaluation of prognostic factors of the current TNM version (UICC/AJCC 2009, 7th revision) for differentiated thyroid carcinoma (DTC). PATIENTS AND METHODS: A total of 368 patients with DTC (papillary thyroid carcinoma [PTC] n = 269, follicular thyroid carcinoma [FTC] n = 99) were included. Disease-specific survival (DSS) was calculated based on the different TNM stages (mean follow-up 60 ± 37.5 months). RESULTS: When compared to patients with FTC, PTC patients had smaller tumors (diameter 19 mm versus 33 mm), more often lymph node metastases (40.9% versus 9.1%) but less frequent distant metastases (2.6 versus 13.1%) and poorly differentiated variants (PDTC 3.0% versus 8.1%). The 5-year and 10-year DSS for PTC versus FTC were 97.3% versus 91.5% and 96.2% versus 91.5% (p = 0.086), respectively. When comparing different TNM categories between well-differentiated PTC and FTC, no statistically significant differences were found but PDTCs, had a significantly worse DSS. CONCLUSIONS: The current TNM system is a sufficient tool for predicting DSS in well-differentiated PTC. In FTC, the extent of capsular and vascular invasion should also be considered. The implementation of a specific TNM system for PDTC needs to be confirmed in further studies.
BACKGROUND: The aim of study was an evaluation of prognostic factors of the current TNM version (UICC/AJCC 2009, 7th revision) for differentiated thyroid carcinoma (DTC). PATIENTS AND METHODS: A total of 368 patients with DTC (papillary thyroid carcinoma [PTC] n = 269, follicular thyroid carcinoma [FTC] n = 99) were included. Disease-specific survival (DSS) was calculated based on the different TNM stages (mean follow-up 60 ± 37.5 months). RESULTS: When compared to patients with FTC, PTC patients had smaller tumors (diameter 19 mm versus 33 mm), more often lymph node metastases (40.9% versus 9.1%) but less frequent distant metastases (2.6 versus 13.1%) and poorly differentiated variants (PDTC 3.0% versus 8.1%). The 5-year and 10-year DSS for PTC versus FTC were 97.3% versus 91.5% and 96.2% versus 91.5% (p = 0.086), respectively. When comparing different TNM categories between well-differentiated PTC and FTC, no statistically significant differences were found but PDTCs, had a significantly worse DSS. CONCLUSIONS: The current TNM system is a sufficient tool for predicting DSS in well-differentiated PTC. In FTC, the extent of capsular and vascular invasion should also be considered. The implementation of a specific TNM system for PDTC needs to be confirmed in further studies.
Authors: Karl Y Bilimoria; David J Bentrem; Clifford Y Ko; Andrew K Stewart; David P Winchester; Mark S Talamonti; Cord Sturgeon Journal: Ann Surg Date: 2007-09 Impact factor: 12.969
Authors: Reza Asari; Oskar Koperek; Christian Scheuba; Philipp Riss; Klaus Kaserer; Martha Hoffmann; Bruno Niederle Journal: Ann Surg Date: 2009-06 Impact factor: 12.969